Quick Summary Franchise Qualifier

2310 W. Victory Blvd
Burbank, CA 91506
Office: 818-565-6252 Fax: 818-479-9722
Quick Summary Franchise Qualifier
Print Form
In order to issue a formal credit approval for franchise financing, we need certain information about you, about your company,
and about your franchise project. The purpose of this form is to provide a quick, summary overview so we can determine which
type of financing would be best for you. If you have any questions, please feel free to give us a call at 818-565-6252. We're
happy to help and look forward to working with you.
GENERAL INFORMATION
Purpose of Financing Request
Total Project Cost
Estimated Closing Date
Amount Requested
Name of Franchisor
Franchise Fee Paid? (Y/N)
Franchise Contact
Location Secured? (Y/N)
BUSINESS INFORMATION
If you have formed a company, please provide the following. If not, proceed to Ownership Information Below
Full Legal Name
Company Address
Company City
State
Phone
Zip Code
Fax
Date Formed
OWNERSHIP INFORMATION
Owner Number 1
Name
Title
Address
City
Years at Current Residence
State
Zip Code
Best Phone Number to Reach
E-mail Address
Currently Employed By
Work Phone
Position
How Long?
Annual Salary
% Ownership
Please summarize your personal credit profile over the last 5 years. Excellent, Good, Average?
Owner Number 2
Name
Title
Address
City
Currently Employed By
Position
Annual Salary
Years at Current Residence
State
Zip Code
Best Phone Number to Reach
E-mail Address
Work Phone
How Long?
% Ownership
Please summarize your personal credit profile over the last 5 years. Excellent, Good, Average?
Page 1 of 4
2310 W. Victory Blvd
Burbank, CA 91506
Office: 818-565-6252 Fax: 818-479-9722
Quick Summary Franchise Qualifier
Print Form
PERSONAL FINANCIAL INFORMATION
Owner Number 1
Personal Cash Flow
Annual
Income
Amount ($)
Annual
Expenses
Personal Balance Sheet
Amount ($)
Assets
Amount ($)
Liabilities
Salary
Mortgage/Rent
Cash on Hand
Notes to Banks
Bonuses &
Commissions
Property Taxes
Securities
Other Notes Owed
Dividends
Annual Taxes
Retirement Accts
Taxes Owed
Real Estate Inc.
Installment Loans
Real Estate
Real Est Mtg
Other Income
Other Expenses
Other Assets
Other Liabilities
Total Income
Total Expenses
Total Assets
Total Liabilities
Amount ($)
Owner Number 2
Personal Cash Flow
Annual
Income
Amount ($)
Annual
Expenses
Personal Balance Sheet
Amount ($)
Assets
Amount ($)
Liabilities
Salary
Mortgage/Rent
Cash on Hand
Notes to Banks
Bonuses &
Commissions
Property Taxes
Securities
Other Notes Owed
Dividends
Annual Taxes
Retirement Accts
Taxes Owed
Real Estate Inc.
Installment Loans
Real Estate
Real Est Mtg
Other Income
Other Expenses
Other Assets
Other Liabilities
Total Income
Total Expenses
Total Assets
Total Liabilities
Amount ($)
Page 2 of 4
2310 W. Victory Blvd
Burbank, CA 91506
Office: 818-565-6252 Fax: 818-479-9722
Quick Summary Franchise Qualifier
Print Form
GENERAL INFORMATION ABOUT YOUR PROJECT
What is your motivation for opening a franchise at this time?
How did you select this particular franchise concept?
Who will manage the day to day operation of this location?
How much of your total family income do you expect to generate as a result of this business?
How much equity do you plan to invest in this business?
Will you be borrowing any funds in addition to this request?
Have you ever owned a business before? Please provide details of that business, such as when you owned it, do you still own it, or
if not, how did you dispose of it?
Which Owners (and/or Spouses) will continue their existing employment?
Page 3 of 4
2310 W. Victory Blvd
Burbank, CA 91506
Office: 818-565-6252 Fax: 818-479-9722
Quick Summary Franchise Qualifier
Print Form
SOURCES & USES OF FUNDS
In addition to this financing request, please describe any other sources of funds you will be using.
And please describe what those Funds will be used for?
List Sources of Funds
Source of Funds
Amount ($)
List Uses of Funds
Uses of Funds
Cash from Bank Accounts
Franchise Fee
Cash from Sale of Stocks,
Bonds, etc
Leasehold
Improvements
Cash from 401k or other
retirements funds
Furn, Fixtures & Equip.
Cash from Bank Lines, Home
equity, etc.
Signage
Any other Borrowed Funds
Point of Sale System
Cash from InSource Financing
Other Capital Costs
Total Sources of Funds
Initial Advertising &
Marketing
Amount ($)
Inventory
Working Capital
Total Uses of Funds
Page 4 of 4